My Blog

Posts for: February, 2015

Although a variety of foods provide energy-producing carbohydrates, sugar is among the most popular. It’s believed we universally crave sugar because of the quick energy boost after eating it, or that it also causes a release in our brains of serotonin endorphins, chemicals which relax us and make us feel good.

But there is a downside to refined sugars like table sugar or high-fructose corn syrup: too much in our diets contributes to conditions like cardiovascular disease, diabetes, and dental disease. On the latter, sugar is a primary food source for oral bacteria; the more sugar available in the mouth the higher the levels of bacteria that lead to tooth decay and gum disease.

Moderating your intake of refined sugars and other carbohydrates can be hard to do, given that many processed foods contain various forms of refined sugar. A diet rich in fresh fruits and vegetables helps control sugar intake as well as contribute to overall health. Many people also turn to a variety of sugar substitutes: one study found roughly 85% of Americans use some form of it in place of sugar. They’re also being added to many processed foods: unless you’re checking ingredients labels, you may be consuming them unknowingly.

Sugar substitutes are generally either artificial, manufactured products like saccharin or aspartame or extractions from natural substances like stevia or sorbitol. The good news concerning your teeth and gums is that all the major sugar substitutes don’t encourage bacterial growth. Still, while they’re generally safe for consumption, each has varying properties and may have side-effects for certain people. For example, people with phenylketonuria, a rare genetic condition, can’t process aspartame properly and should avoid it.

One alcohol-based sweetener in particular is of interest in oral care. A number of studies indicate xylitol may actually inhibit bacterial growth and thus reduce the risk of tooth decay. You can find xylitol in a variety of gum and mint products.

When considering what sugar substitutes to use, be sure you’re up to date on their potential health effects for certain individuals, as well as check the ingredients labels of processed foods for added sweeteners. As your dentist, we’ll also be glad to advise you on strategies to reduce sugar in your diet and promote better dental health.

We all know that dentistry can do amazing things these days to give you the smile you've always dreamed of. With the latest cosmetic and restorative dental techniques, it is possible to achieve amazingly natural-looking results. But how do we map out the best route to a better smile? And how do we know that the results will hold up over time?

Every individual has a unique set of conditions in his or her mouth and it is our job to figure out how you have come to your present state, dentally speaking. We need to correct or at least manage any factors that could risk the success of your treatment. These risk factors fall into four basic categories:

Periodontal Risk — This involves the condition of the structures that support your teeth, including your gum and bone tissue. It's important to establish good periodontal health before we perform any restorative or cosmetic procedures.

Biomechanical Risk — This has to do with the structural integrity of your teeth. We will look at whether any tooth structure has been lost due to decay, and take steps to reduce your susceptibility to decay if necessary.

Functional Risk — This relates to your bite: how your teeth, muscles and jaw joints are functioning. For example, do you have excessive tooth wear or joint pain? If so, you are at a higher risk in this category and we need to figure out why.

Aesthetic Risk — This is the most subjective of the categories as beauty is in the eye of the beholder. Still, if you display a lot of your teeth and gums when you smile, any issues you have (gum recession, for example) will be that much more visible and affect your smile more. We will have to take this into account when we plan your treatment.

Only when we have determined how best to minimize your risk in all four of these categories can we restore or enhance your smile in a way that will not only look great but also last as long as possible.

Tooth sensitivity is an all too common problem among dental patients. If eating certain foods or simply touching a tooth causes you pain, you should know why this may be happening and what can be done about it.

Tooth sensitivity occurs in most cases because the portion of the tooth known as the dentin has been exposed. The dentin contains nerve fibers that inform and alert the brain about the current environment of the tooth (temperature or pressure changes). The enamel protects the tooth from environmental extremes.

Receding gums are the most common cause for dentin exposure — the enamel only protects the crown of the tooth and is not present on the root of the tooth. Acids in certain foods can then begin to erode the dentin around the roots and expose nerves. Sweet items (mainly sugar) and temperature shifts irritate the nerve endings, causing pain.

While receding gums (most commonly caused by brushing too hard and too often) may be the most common cause for sensitivity, it isn't the only one — tooth decay may also lead to it. Untreated, decay works its way into the tooth pulp and irritates the nerves. Treating the decay and filling the tooth may also cause sensitivity unless the dentist places a lining designed to minimize it temporarily while the area heals.

Alleviating pain from sensitivity begins with how you brush your teeth. Remember: the goal of brushing is to remove plaque, which does not require vigorous action. Brush gently with a soft-bristled brush and not too often. We might even recommend not brushing a very sensitive tooth for a few days to give the tooth a rest. You should also brush with a toothpaste containing fluoride, which will help strengthen the tooth surface against the effects of acids and sweets.

During an office visit, we can also apply a fluoride varnish or use certain filling materials that will serve as a barrier for the sensitive area. For cases where decay has irreversibly damaged the tooth pulp, a root canal may be the best treatment.

Tooth sensitivity isn't necessarily something you have to live with. There are treatments that can relieve or lessen the pain.

If you would like more information on tooth sensitivity and what can be done about it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”

The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.

At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.

Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.

Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.

At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.